CMS releases CY 2021 proposed rule for physician fee schedule payments

The Centers for Medicare & Medicaid Services Aug. 3 issued a proposed rule that would update physician fee schedule payments for calendar year 2021. The rule also included several proposals to implement year five of the quality payment program created by the Medicare Access and CHIP Reauthorization Act of 2015.

Among other proposals, CMS would:

  • Reduce the PFS conversion factor by 10.61% for CY 2021;
  • Add services to the Medicare telehealth list of services and make other changes to retain certain COVID-19 telehealth flexibilities;
  • Increase payment rates for office/outpatient evaluation and management visits;
  • Implement changes to enable health care professionals to practice at the top of their licenses;
  • Delay the next Clinical Laboratory Fee Schedule data reporting period by an additional year so that hospital outreach laboratories would not need to report private payer data until Jan. 1, 2022 through March 31, 2022;
  • Eliminate the phase-in of CLFS payment cuts in 2021; and
  • Implement provisions of the Substance Use-disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act, including Medicare coverage for opioid treatment programs, screening for substance use disorder in Medicare physicals, and electronic prescribing of controlled substances.

Comments on the proposed rule are due by Oct. 5.

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